Hong Kong Journal of Emergency Medicine · Published 2026-07-21 · DOI 10.1002/hkj2.70119
Lianmei Guo, Jing Wang, Qiuxiang Hu
Abstract Background Upper gastrointestinal bleeding (UGIB) is a life‐threatening emergency. This study evaluated the effects of a bundle care strategy on rebleeding and prognosis in patients with UGIB in the emergency observation area. Methods A retrospective cohort study was conducted among 206 patients with UGIB admitted to the emergency observation area from January 2024 to December 2025. UGIB cases were identified using ICD‐10 discharge diagnosis codes combined with clinical manifestations and/or endoscopic confirmation. Patients were assigned to an observation group receiving bundle care and a control group receiving conventional nursing care, with 103 patients in each group. The bundle care strategy was developed through literature review, evidence grading, and a modified Delphi consensus process, and nurses received standardized training before implementation. Five core components were finalized: rapid assessment and risk stratification, standardized hemodynamic monitoring, targeted medication administration, structured psychological support and health education, and coordinated multidisciplinary care. Primary outcomes were rebleeding rate and hemostasis time; secondary outcomes included hospital stay, anxiety and depression scores, nursing satisfaction, and 30‐day mortality. Results The observation group demonstrated significantly lower rebleeding rates compared to the control group (5.83% vs. 15.53%, p = 0.024). Hemostasis time was significantly shorter in the observation group (26.47 ± 8.32 h vs. 35.68 ± 11.54 h, p < 0.001). The length of hospital stay was reduced in the observation group (5.12 ± 1.87 days vs. 7.45 ± 2.63 days, p < 0.001). Postintervention anxiety scores (SAS: 41.26 ± 6.83 vs. 48.57 ± 7.92, p < 0.001) and depression scores (SDS: 42.38 ± 7.15 vs. 49.23 ± 8.46, p < 0.001) were significantly lower in the observation group. Nursing satisfaction was significantly higher in the observation group (96.12% vs. 84.47%, p = 0.006). The 30‐day mortality rate showed no statistically significant difference between groups (1.94% vs. 4.85%, p = 0.247). Conclusions Bundle care strategy effectively reduced rebleeding, shortened hemostasis time and hospital stay, relieved psychological distress, and improved nursing satisfaction in patients with UGIB.
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Guo, L., Wang, J., Hu, Q. (2026). Effect of bundle care strategy on rebleeding rate and prognosis of patients with upper gastrointestinal bleeding in emergency observation area. Hong Kong Journal of Emergency Medicine. https://doi.org/10.1002/hkj2.70119